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Reviewed by Dr Samantha Miller MB ChB
(2017, University of Glasgow)
GMC number: 7561464
Information last reviewed 28/03/2021
Thrush is an inflammation caused by a fungal infection with one of the Candida yeasts. It most commonly affects women, causing itching and irritation around the vulva and inside the vagina, however, it can also be experienced by men. Common symptoms include redness, itching and discomfort of the vagina and vulva and a white, odourless discharge. Thrush is not a sexually transmitted infection although it can be passed on during sex.
Most cases of thrush are caused by infection with one of the Candida yeasts, most commonly Candida albicans. These fungi can naturally reside inside the vagina without causing any symptoms, and this doesn’t necessarily require treatment. Thrush arises when an overgrowth of this yeast causes symptoms.
There are several common triggers that can increase the risk of developing thrush:
In women, thrush typically occurs around the vulva and vagina, however can also extend to the area around the anus, or to the inner thighs. Men can also experience thrush on the tip of the penis or under the foreskin. You can also get oral thrush inside the mouth which is more common if you are immunocompromised, use steroid inhalers or wear dentures.
Thrush can occur in both men and women and is caused by the same type of fungus – Candida. Candida exists naturally in small numbers as part of the normal bugs that live on the skin, gut, respiratory system and female reproductive tract, and usually only causes symptoms where there is overgrowth. Thrush in women is referred to as vulvovaginal candidiasis, and in men, it is referred to as candidal balanitis.
Oral thrush affects the inside of the mouth. It tends to be caused by asthma inhalers, antibiotics, chemotherapy or dentures. It is also fairly common in babies. The symptoms include having a white coating on the tongue, soreness of the tongue and an unpleasant taste in the mouth. Oral thrush is caused by the same type of yeast as genital thrush. Genital thrush mainly affects women, causing itching and discomfort around the vulva and inside the vagina. It can be triggered by various factors such as sweating, using perfumed hygiene products, wearing tight clothing and sex, however, it can also occur with no obvious cause.
In women, the symptoms of thrush may include:
The symptoms of oral thrush include:
Thrush and bacterial vaginosis (BV) both affect the vulvovaginal area and are both caused by an imbalance in the normal bugs present in this area, but there are differences between the two. Thrush is a fungal infection caused by the Candida yeast whereas bacterial vaginosis is a bacterial infection that occurs if the pH balance (acidity) of the vagina is altered. The symptoms of thrush include itching, redness and irritation and it produces a white, cottage cheese-like discharge. BV causes a more watery discharge which often has a characteristic fishy smell and it can cause a burning sensation during urination but does not typically cause itching.
There are several factors that can contribute to a bout of thrush. These steps can help to prevent thrush from happening again:
There are several treatments available for thrush:
Oral and intravaginal antifungals are equally effective for treating vulvovaginal thrush. In a minority of women, recurrent thrush can occur, and if this happens, it’s important to see your doctor to rule out any underlying causes such as diabetes. You may be prescribed a prolonged course of oral antifungal agents, or your doctor may wish to take a swab from your vagina to check which type of bugs are present.
Avoiding potential triggers can help to stop frequent bouts of thrush. These include:
Thrush usually clears up within a week, although it can take up to two weeks for the symptoms to completely disappear.
Many thrush treatments are available both on prescription and over the counter. If you have had thrush before, then you can buy thrush treatments directly from a pharmacy. It's recommended to see a GP if you have never had thrush before, to make sure that it’s definitely thrush causing your symptoms.
Oral capsules, pessaries and intravaginal creams are equally effective at treating thrush. It may depend on personal preference and comfort which one is best. Oral capsules provide greater convenience, however intravaginal creams and pessaries may have less systemic side effects. Oral antifungal treatments are not suitable for pregnant women as they can increase the risk of miscarriage.
If you have recurrent thrush, seek advice from your GP. They may do further tests to find out the underlying cause and prescribe you with an alternative antifungal or a longer course of treatment.
The candida fungi multiply in warm, moist conditions. The following steps can help to prevent thrush from recurring:
If you only have mild symptoms, thrush might resolve on its own. While thrush is not serious, the symptoms can be uncomfortable and it’s easily treated.
During pregnancy, thrush should be treated with an intravaginal cream alongside the external cream for use around the vulva. Oral tablets are not suitable for pregnant women and can heighten the risk of a miscarriage. The internal cream should be applied carefully to avoid the cervix.
Loose-fitting underwear made from natural (not synthetic) materials such as cotton or silk are best for reducing your risk of thrust, as these materials allow your skin to breathe.
If you're having treatment for thrush it can take up to a week for the infection to clear up. The symptoms of thrush are often uncomfortable. If you have symptoms of thrush around the vulva, the use of a topical antifungal cream such as Canesten may help to soothe the itching and irritation. Be sure to drink plenty of water, which may make painful urination more tolerable. Mild painkillers such as paracetamol or ibuprofen can also be used if you are able to take these. Remember ibuprofen is not suitable for those who are pregnant. You might also want to avoid activities such as sex, hot baths and swimming, as this may exacerbate your symptoms.
No, thrush is caused by a type of fungus rather than bacteria. It happens when the Candida yeast multiplies more than normal. This can be triggered by bacterial changes in the vagina. Thrush can co-exist with bacterial infections such as chlamydia and gonorrhoea, so it might be worth having a full sexual health screen if you have symptoms of vaginal discharge.
Stress is a possible trigger for causing thrush. This is because stress can lower the immune system, leaving the body feeling run down and more vulnerable to infection.
Thrush is a yeast infection. It is caused by the Candida yeast which usually lives harmlessly inside the vagina. It turns into a yeast infection when the natural balance inside the vagina is disrupted, triggering an overgrowth of the Candida yeast.
The first time you get thrush you should see your GP for an accurate diagnosis to rule out other possible causes. Thrush can often be diagnosed clinically, i.e. from your history and a physical examination, however, your doctor may wish to obtain a swab from the vagina to confirm the diagnosis. If you are successfully treated for thrush and experience the same symptoms in the future, you can go ahead and purchase your own treatment.
High blood sugar creates an ideal environment for yeast to grow which is why thrush is more common in people with diabetes. If you are diabetic, your immune system may also be lower, which also makes you more likely to get thrush.
Antibiotics work by killing bacteria that cause an infection. They cause thrush because they also kill off some of the harmless bacteria which are present in the vagina which would normally compete with yeast and keep it in check.
Thrush is not a sexually transmitted infection but it can be passed on during sex if you or your partner has a yeast infection. Sex can also be a trigger for the development of thrush, even if neither you nor your partner has had thrush before.
You should avoid sex until your thrush clears up. Sex can be uncomfortable or painful when you have a thrush infection and intercourse can make the infection worse. It can also slow the progress of your treatment and risks passing it on to your partner.
The symptoms of thrush primarily include itching and discomfort around the entrance to the vagina, redness and a white, odourless discharge. You may also experience discomfort during sex. These symptoms can be similar to those from a sexually transmitted infection.
Other symptoms of an STI may include:
If you are in any doubt, then visit a sexual health clinic or order one of our discreet home testing kits to get tested.
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